Can You Have a Concussion Without Losing Consciousness?

Who this is for: Written for crash patients who never lost consciousness and the families and providers who hear "I didn't black out, so I'm fine."

A common misconception

Many people believe that if they did not black out, they could not have had a concussion. They say it to providers, to insurers and to their families: "I didn't lose consciousness, so I'm fine."

It is not true. Loss of consciousness is not required for a concussion, and most guideline definitions, including the 2023 ACRM criteria and the international sport consensus, do not require it. Feeling dazed or confused, "seeing stars" or having a gap in memory around the event can all be signs. Some people have none of these, and develop symptoms later.

Most guideline definitions, including ACRM 2023 and the international sport consensus, do not require loss of consciousness for a concussion diagnosis.

Why the myth persists

Movies and sports broadcasts tend to portray concussions as dramatic knockouts. ER paperwork asks specifically about loss of consciousness, because it matters for certain decisions, and patients can come away thinking it is the only thing that counts. And people naturally want to believe they are fine.

Signs to watch for instead

After a crash or fall, pay attention to headache, dizziness, nausea, feeling foggy or slowed down, trouble concentrating, memory problems, sensitivity to light or noise, irritability, emotional changes and sleep changes. Ask family members whether you have been repeating questions or seeming off. Write down when each symptom began.

Related in this series: Why a CT Scan Can Miss a Concussion, Delayed Concussion Symptoms: Why They Show Up Days Later and Head Injury Red Flags: When to Go to the ER Right Away. For the full overview, start with our guide, Concussion After a Crash.

What to tell your provider

Describe the impact honestly, including whether your head struck something or was jolted, and say clearly that you did not lose consciousness if that is the case. Then describe every symptom you have noticed since. That gives the provider an accurate picture without overstating or understating the event.

Whether or not you blacked out, the symptoms since are what deserve attention.

Children and older adults

Children may not be able to describe what they feel, and older adults may have their symptoms put down to age. In both groups, watch for behavior changes, unusual sleepiness, irritability or unsteadiness after any head impact, and get them evaluated even when there was no blackout.

When testing may help

If symptoms persist, standardized testing measures brain function directly, whether or not consciousness was lost. Braintree performs testing at your treating provider's office, and a physician reviews the results.

For attorneys and adjusters: the absence of loss of consciousness in the records does not, by itself, describe whether a client has functional symptoms. Read the full clinical picture. Braintree reports describe findings only.

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